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Clinical Reasoning Case Study #77 Endocrine Disorders

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Submitted By givanb2
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Case study 76 Endocrine Disorders
1. Interpret Y.L.'s laboratory results
• HbA1C is elevated at 8.8% and the goal for diabetics is to keep that value below 7%
Hemoglobin A1c. Her number is concerning because it indicates that her blood sugar has been way too high over the past few months. The A1c is an indication of glycosylation in the body which is damaging to the blood vessels and peripheral nerves. It causes thickening of the basement membrane which will impair oxygen transport to the tissues and carbon dioxide removal.
• High BP
• Total Cholesterol is elevated at 256mg/dL, normal value is below 200mg/dL
• Fasting glucose is high at 184mg/dL, normal value is below 126mg/dL
• Triglycerides are elevated at 346 mg/dL, normal levels are below 150mg/dL. Y.L. indicates levels that are high.
• LDL levels are elevated at 155mg/dL and ideal values are below 100mg/dL; LDL is the value you want to be the lowest.
• HDL levels are low and the HDL levels need to be high, 40-60mg/dL is desired.
• Urine Analysis indicates that Y.L. is spilling glucose into her urine.

2. Identify the three methods used to diagnose DM.
- Fasting blood glucose of > 126 mg/dl
- Random Glucose Level >200 mg/dl (plus presence of other symptoms)
- A1C > 6.5%

3. Identify three functions of insulin.
• regulates glucose metabolism
• stimulates lipogenesis
• stimulates growth

4. Describe the major pathophysiologic difference between type 1 and type 2 DM.
• Type 1 diabetes, the body produces insufficient insulin to regulate blood glucose levels, known as ‘insulin dependent’.

• Type 2 diabetes, the body produces sufficient insulin, but the body’s cells do not respond effectively to insulin, thus ‘insulin resistant’.
5. What are the risk factors for type 2 DM? Place a star or asterisk next to those that Y.L. exhibits.
• *Weight
• Fat distribution primarily

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